Fernanda Freire Jannuzzi

Atividades de lazer em idosos durante a hospitalização

This study intended to: 1. Identify the leisure activities available in the hospital and those in which the elderly participate; 2. Relate elderly hospitalization with their participation in leisure activities; 3. Assess the factors that motivate and inhibit elderly participation in leisure activities. This is a descriptive/exploratory study carried out with one hundred hospitalized elderly patients. Available leisure activities were television and magazines. Most participants (99%) said they participate in leisure activities such as family/friends conversations and visits. Involvement in leisure activities decreases with associated diseases and increases with hospitalization time. Leisure was motivated by the elderlys personal characteristics, the reduction of the hospitalizations negative effects, and the benefits it brings to the health. Its limitation was associated to intrinsic aspects of the elderly and to the institutional context.This study intended to: 1. Identify the leisure activities available in the hospital and those in which the elderly participate; 2. Relate elderly hospitalization with their participation in leisure activities; 3. Assess the factors that motivate and inhibit elderly participation in leisure activities. This is a descriptive/exploratory study carried out with one hundred hospitalized elderly patients. Available leisure activities were television and magazines. Most participants (99%) said they participate in leisure activities such as family/ friends conversations and visits. Involvement in leisure activities decreases with associated diseases and increases with hospitalization time. Leisure was motivated by the elderlys personal characteristics, the reduction of the hospitalizations negative effects, and the benefits it brings to the health. Its limitation was associated to intrinsic aspects of the elderly and to the institutional context.Este estudio tuvo como objetivos: 1. Identificar las actividades recreativas disponibles en el hospital y las realizadas por los ancianos; 2. Relacionar el internamiento con participacion en las actividades recreativas; 3. Evaluar los factores que motivan e impiden la participacion en estas actividades. Se trata de una investigacion descriptiva/exploratoria, con 100 ancianos hospitalizados. Las actividades disponibles fueron: television y revistas. La mayoria de los sujetos (99%) afirmo participar de actividades recreativas, destacandose la conversacion, la visita de familiares/amigos. La participacion en otras actividades disminuye con las comorbilidades y aumenta con el internamiento. La recreacion fue motivada por las caracteristicas personales de los ancianos, reduccion de los efectos de la hospitalizacion y beneficios para la salud. Su limitacion se asocio a los aspectos intrinsecos de los ancianos y al contexto institucional.

Beliefs related to adherence to oral antidiabetic treatment according to the Theory of Planned Behavior

OBJECTIVE: to identify salient behavioral, normative, control and self-efficacy beliefs related to the behavior of adherence to oral antidiabetic agents, using the Theory of Planned Behavior. METHOD: cross-sectional, exploratory study with 17 diabetic patients in chronic use of oral antidiabetic medication and in outpatient follow-up. Individual interviews were recorded, transcribed and content-analyzed using pre-established categories. RESULTS: behavioral beliefs concerning advantages and disadvantages of adhering to medication emerged, such as the possibility of avoiding complications from diabetes, preventing or delaying the use of insulin, and a perception of side effects. The children of patients and physicians are seen as important social references who influence medication adherence. The factors that facilitate adherence include access to free-of-cost medication and taking medications associated with temporal markers. On the other hand, a complex therapeutic regimen was considered a factor that hinders adherence. Understanding how to use medication and forgetfulness impact the perception of patients regarding their ability to adhere to oral antidiabetic agents. CONCLUSION: medication adherence is a complex behavior permeated by behavioral, normative, control and self-efficacy beliefs that should be taken into account when assessing determinants of behavior.OBJETIVO: identificar as crencas salientes comportamentais, normativas, de controle e de autoeficacia, relacionadas ao comportamento de adesao aos antidiabeticos orais, utilizando a Teoria do Comportamento Planejado. METODO: estudo transversal, exploratorio, com 17 diabeticos, em uso continuo de antidiabetico oral, em seguimento ambulatorial. As entrevistas individuais foram gravadas, transcritas e submetidas a analise de conteudo, utilizando-se categorias pre-definidas. RESULTADOS: emergiram crencas comportamentais relacionadas as vantagens e desvantagens do uso dos medicamentos, como a possibilidade de evitar complicacoes do diabetes, evitar ou retardar o uso de insulina e percepcao de reacoes adversas. Evidenciou-se que os filhos e o medico sao importantes referentes sociais que influenciam a adesao medicamentosa. Dentre os fatores que facilitam a adesao destacaram-se o acesso gratuito aos medicamentos e a tomada dos medicamentos relacionada a marcadores temporais. A complexidade terapeutica, por outro lado, foi considerada fator que dificulta a adesao. A compreensao da forma de uso dos medicamentos e o esquecimento impactam a percepcao da capacidade de aderir aos antidiabeticos orais. CONCLUSAO: a adesao medicamentosa e um comportamento complexo, permeado por crencas comportamentais, normativas, de controle e autoeficacia que devem ser consideradas na avaliacao dos determinantes do comportamento.

Medication adherence and quality of life among the elderly with diabetic retinopathy

Objetivo: investigar os fatores relacionados a adesao medicamentosa e sua relacao com a qualidade de vida relacionada a saude em idosos com retinopatia diabetica. Metodo: foram entrevistados 100 idosos, em acompanhamento ambulatorial, em uso de anti-hipertensivos e/ ou antidiabeticos orais/insulina. A adesao foi avaliada pela proporcao de adesao e sua associacao com os cuidados no uso dos medicamentos e pela Escala de Morisky. O National Eye Institute Visual Funcioning Questionnaire foi utilizado para avaliar a qualidade de vida relacionada a saude. Resultados: A maioria (58%) relatou o uso de 80% ou mais das doses prescritas e os cuidados na tomada dos medicamentos. O item “interromper o uso dos medicamentos por se sentir pior”, da Escala de Morisky, explicou 12,8 e 13,5% da variabilidade da proporcao de adesao aos anti-hipertensivos e aos antidiabeticos orais/insulina, respectivamente. Conclusao: observou-se melhor qualidade de vida relacionada a saude nos dominios visao de cores, dirigir automovel e apectos sociais do National Eye Institute Visual Funcioning Questionnaire. Individuos com menor pontuacao na National Eye Institute Visual Funcioning Questionnaire e maiores escores na Escala de Morisky apresentaram maiores chances de serem nao aderentes aos medicamentos do diabetes e da hipertensao arterial.

Quality of Life on Arterial Hypertension: Validity of Known Groups of MINICHAL.

Introductions In the care of hypertension, it is important that health professionals possess available tools that allow evaluating the impairment of the health-related quality of life, according to the severity of hypertension and the risk for cardiovascular events. Among the instruments developed for the assessment of health-related quality of life, there is the Mini-Cuestionario of Calidad de Vida en la Hipertensión Arterial (MINICHAL) recently adapted to the Brazilian culture. Objective To estimate the validity of known groups of the Brazilian version of the MINICHAL regarding the classification of risk for cardiovascular events, symptoms, severity of dyspnea and target-organ damage. Methods Data of 200 hypertensive outpatients concerning sociodemographic and clinical information and health-related quality of life were gathered by consulting the medical charts and the application of the Brazilian version of MINICHAL. The Mann-Whitney test was used to compare health-related quality of life in relation to symptoms and target-organ damage. The Kruskal-Wallis test and ANOVA with ranks transformation were used to compare health-related quality of life in relation to the classification of risk for cardiovascular events and intensity of dyspnea, respectively. Results The MINICHAL was able to discriminate health-related quality of life in relation to symptoms and kidney damage, but did not discriminate health-related quality of life in relation to the classification of risk for cardiovascular events. Conclusion The Brazilian version of the MINICHAL is a questionnaire capable of discriminating differences on the health‑related quality of life regarding dyspnea, chest pain, palpitation, lipothymy, cephalea and renal damage.

A randomized controlled trial on the effect of behavioral strategies for adherence to oral antidiabetic drugs: study protocol

Background: Non-adherence to oral antidiabetics drugs (OADs) has been a common problem and may contribute to poor glycemic control. Aim: To describe an experimental study protocol that aims at implementing and evaluating the effect of the “action planning and coping planning” interventions on medication adherence to OADs in patients with type 2 diabetes mellitus (T2DM) in follow-up at primary care services. Design: A randomized controlled trial. Methods: Two groups (intervention and control) will be followed over a period of 105 days. The intervention group will receive a combination of the “action planning” and “coping planning” intervention strategies. There will be in-person meetings and phone calls to reinforce the intervention. The control group will receive the usual care from the health unit. Conclusions: It is hoped that this study will help health professionals to improve their approach with patients who have T2DM in relation to medication adherence.

Adesão medicamentosa e qualidade de vida em idosos com retinopatia diabética

Objetivo: investigar os fatores relacionados a adesao medicamentosa e sua relacao com a qualidade de vida relacionada a saude em idosos com retinopatia diabetica. Metodo: foram entrevistados 100 idosos, em acompanhamento ambulatorial, em uso de anti-hipertensivos e/ ou antidiabeticos orais/insulina. A adesao foi avaliada pela proporcao de adesao e sua associacao com os cuidados no uso dos medicamentos e pela Escala de Morisky. O National Eye Institute Visual Funcioning Questionnaire foi utilizado para avaliar a qualidade de vida relacionada a saude. Resultados: A maioria (58%) relatou o uso de 80% ou mais das doses prescritas e os cuidados na tomada dos medicamentos. O item “interromper o uso dos medicamentos por se sentir pior”, da Escala de Morisky, explicou 12,8 e 13,5% da variabilidade da proporcao de adesao aos anti-hipertensivos e aos antidiabeticos orais/insulina, respectivamente. Conclusao: observou-se melhor qualidade de vida relacionada a saude nos dominios visao de cores, dirigir automovel e apectos sociais do National Eye Institute Visual Funcioning Questionnaire. Individuos com menor pontuacao na National Eye Institute Visual Funcioning Questionnaire e maiores escores na Escala de Morisky apresentaram maiores chances de serem nao aderentes aos medicamentos do diabetes e da hipertensao arterial.

Adhesión a la medicación y calidad de vida en ancianos con retinopatía diabética

Objetivo: investigar os fatores relacionados a adesao medicamentosa e sua relacao com a qualidade de vida relacionada a saude em idosos com retinopatia diabetica. Metodo: foram entrevistados 100 idosos, em acompanhamento ambulatorial, em uso de anti-hipertensivos e/ ou antidiabeticos orais/insulina. A adesao foi avaliada pela proporcao de adesao e sua associacao com os cuidados no uso dos medicamentos e pela Escala de Morisky. O National Eye Institute Visual Funcioning Questionnaire foi utilizado para avaliar a qualidade de vida relacionada a saude. Resultados: A maioria (58%) relatou o uso de 80% ou mais das doses prescritas e os cuidados na tomada dos medicamentos. O item “interromper o uso dos medicamentos por se sentir pior”, da Escala de Morisky, explicou 12,8 e 13,5% da variabilidade da proporcao de adesao aos anti-hipertensivos e aos antidiabeticos orais/insulina, respectivamente. Conclusao: observou-se melhor qualidade de vida relacionada a saude nos dominios visao de cores, dirigir automovel e apectos sociais do National Eye Institute Visual Funcioning Questionnaire. Individuos com menor pontuacao na National Eye Institute Visual Funcioning Questionnaire e maiores escores na Escala de Morisky apresentaram maiores chances de serem nao aderentes aos medicamentos do diabetes e da hipertensao arterial.

Crenças relacionadas à adesão ao tratamento com antidiabéticos orais segundo a Teoria do Comportamento Planejado

OBJECTIVE: to identify salient behavioral, normative, control and self-efficacy beliefs related to the behavior of adherence to oral antidiabetic agents, using the Theory of Planned Behavior. METHOD: cross-sectional, exploratory study with 17 diabetic patients in chronic use of oral antidiabetic medication and in outpatient follow-up. Individual interviews were recorded, transcribed and content-analyzed using pre-established categories. RESULTS: behavioral beliefs concerning advantages and disadvantages of adhering to medication emerged, such as the possibility of avoiding complications from diabetes, preventing or delaying the use of insulin, and a perception of side effects. The children of patients and physicians are seen as important social references who influence medication adherence. The factors that facilitate adherence include access to free-of-cost medication and taking medications associated with temporal markers. On the other hand, a complex therapeutic regimen was considered a factor that hinders adherence. Understanding how to use medication and forgetfulness impact the perception of patients regarding their ability to adhere to oral antidiabetic agents. CONCLUSION: medication adherence is a complex behavior permeated by behavioral, normative, control and self-efficacy beliefs that should be taken into account when assessing determinants of behavior.OBJETIVO: identificar as crencas salientes comportamentais, normativas, de controle e de autoeficacia, relacionadas ao comportamento de adesao aos antidiabeticos orais, utilizando a Teoria do Comportamento Planejado. METODO: estudo transversal, exploratorio, com 17 diabeticos, em uso continuo de antidiabetico oral, em seguimento ambulatorial. As entrevistas individuais foram gravadas, transcritas e submetidas a analise de conteudo, utilizando-se categorias pre-definidas. RESULTADOS: emergiram crencas comportamentais relacionadas as vantagens e desvantagens do uso dos medicamentos, como a possibilidade de evitar complicacoes do diabetes, evitar ou retardar o uso de insulina e percepcao de reacoes adversas. Evidenciou-se que os filhos e o medico sao importantes referentes sociais que influenciam a adesao medicamentosa. Dentre os fatores que facilitam a adesao destacaram-se o acesso gratuito aos medicamentos e a tomada dos medicamentos relacionada a marcadores temporais. A complexidade terapeutica, por outro lado, foi considerada fator que dificulta a adesao. A compreensao da forma de uso dos medicamentos e o esquecimento impactam a percepcao da capacidade de aderir aos antidiabeticos orais. CONCLUSAO: a adesao medicamentosa e um comportamento complexo, permeado por crencas comportamentais, normativas, de controle e autoeficacia que devem ser consideradas na avaliacao dos determinantes do comportamento.

Creencias relacionadas a la adhesión al tratamiento con antidiabéticos orales según la Teoría del Comportamiento Planificado

OBJECTIVE: to identify salient behavioral, normative, control and self-efficacy beliefs related to the behavior of adherence to oral antidiabetic agents, using the Theory of Planned Behavior. METHOD: cross-sectional, exploratory study with 17 diabetic patients in chronic use of oral antidiabetic medication and in outpatient follow-up. Individual interviews were recorded, transcribed and content-analyzed using pre-established categories. RESULTS: behavioral beliefs concerning advantages and disadvantages of adhering to medication emerged, such as the possibility of avoiding complications from diabetes, preventing or delaying the use of insulin, and a perception of side effects. The children of patients and physicians are seen as important social references who influence medication adherence. The factors that facilitate adherence include access to free-of-cost medication and taking medications associated with temporal markers. On the other hand, a complex therapeutic regimen was considered a factor that hinders adherence. Understanding how to use medication and forgetfulness impact the perception of patients regarding their ability to adhere to oral antidiabetic agents. CONCLUSION: medication adherence is a complex behavior permeated by behavioral, normative, control and self-efficacy beliefs that should be taken into account when assessing determinants of behavior.OBJETIVO: identificar as crencas salientes comportamentais, normativas, de controle e de autoeficacia, relacionadas ao comportamento de adesao aos antidiabeticos orais, utilizando a Teoria do Comportamento Planejado. METODO: estudo transversal, exploratorio, com 17 diabeticos, em uso continuo de antidiabetico oral, em seguimento ambulatorial. As entrevistas individuais foram gravadas, transcritas e submetidas a analise de conteudo, utilizando-se categorias pre-definidas. RESULTADOS: emergiram crencas comportamentais relacionadas as vantagens e desvantagens do uso dos medicamentos, como a possibilidade de evitar complicacoes do diabetes, evitar ou retardar o uso de insulina e percepcao de reacoes adversas. Evidenciou-se que os filhos e o medico sao importantes referentes sociais que influenciam a adesao medicamentosa. Dentre os fatores que facilitam a adesao destacaram-se o acesso gratuito aos medicamentos e a tomada dos medicamentos relacionada a marcadores temporais. A complexidade terapeutica, por outro lado, foi considerada fator que dificulta a adesao. A compreensao da forma de uso dos medicamentos e o esquecimento impactam a percepcao da capacidade de aderir aos antidiabeticos orais. CONCLUSAO: a adesao medicamentosa e um comportamento complexo, permeado por crencas comportamentais, normativas, de controle e autoeficacia que devem ser consideradas na avaliacao dos determinantes do comportamento.

Actividades recreativas de ancianos durante la hospitalización

This study intended to: 1. Identify the leisure activities available in the hospital and those in which the elderly participate; 2. Relate elderly hospitalization with their participation in leisure activities; 3. Assess the factors that motivate and inhibit elderly participation in leisure activities. This is a descriptive/exploratory study carried out with one hundred hospitalized elderly patients. Available leisure activities were television and magazines. Most participants (99%) said they participate in leisure activities such as family/friends conversations and visits. Involvement in leisure activities decreases with associated diseases and increases with hospitalization time. Leisure was motivated by the elderlys personal characteristics, the reduction of the hospitalizations negative effects, and the benefits it brings to the health. Its limitation was associated to intrinsic aspects of the elderly and to the institutional context.This study intended to: 1. Identify the leisure activities available in the hospital and those in which the elderly participate; 2. Relate elderly hospitalization with their participation in leisure activities; 3. Assess the factors that motivate and inhibit elderly participation in leisure activities. This is a descriptive/exploratory study carried out with one hundred hospitalized elderly patients. Available leisure activities were television and magazines. Most participants (99%) said they participate in leisure activities such as family/ friends conversations and visits. Involvement in leisure activities decreases with associated diseases and increases with hospitalization time. Leisure was motivated by the elderlys personal characteristics, the reduction of the hospitalizations negative effects, and the benefits it brings to the health. Its limitation was associated to intrinsic aspects of the elderly and to the institutional context.Este estudio tuvo como objetivos: 1. Identificar las actividades recreativas disponibles en el hospital y las realizadas por los ancianos; 2. Relacionar el internamiento con participacion en las actividades recreativas; 3. Evaluar los factores que motivan e impiden la participacion en estas actividades. Se trata de una investigacion descriptiva/exploratoria, con 100 ancianos hospitalizados. Las actividades disponibles fueron: television y revistas. La mayoria de los sujetos (99%) afirmo participar de actividades recreativas, destacandose la conversacion, la visita de familiares/amigos. La participacion en otras actividades disminuye con las comorbilidades y aumenta con el internamiento. La recreacion fue motivada por las caracteristicas personales de los ancianos, reduccion de los efectos de la hospitalizacion y beneficios para la salud. Su limitacion se asocio a los aspectos intrinsecos de los ancianos y al contexto institucional.